PMID- 36937920
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230321
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 10
DP  - 2023
TI  - Racial disparities in characteristics and outcomes of patients undergoing mitral 
      transcatheter edge-to-edge repair.
PG  - 1111714
LID - 10.3389/fcvm.2023.1111714 [doi]
LID - 1111714
AB  - BACKGROUND: There are scarce data regarding the post-mitral transcatheter 
      edge-to-edger repair (TEER) course in different racial groups. OBJECTIVE: To 
      assess the impact of race on outcomes following TEER for mitral regurgitation 
      (MR). METHODS: This is a single-center, retrospective analysis of consecutive 
      TEER procedures performed during 2013-2020. The primary outcome was the composite 
      of all-cause mortality or heart failure (HF) hospitalizations along the first 
      postprocedural year. Secondary outcomes included individual components of the 
      primary outcome, New York Heart Association (NYHA) class, MR grade, and left 
      ventricular mass index (LVMi). RESULTS: Out of 964 cases, 751 (77.9%), 88 (9.1%), 
      68 (7.1%), and 57 (5.9%) were whites, blacks, Asians, and Hispanics, 
      respectively. At baseline, non-whites and blacks were younger and more likely be 
      female, based in lower socioeconomic areas, not fully insured, diagnosed with 
      functional MR, and affected by biventricular dysfunction. Intra-procedurally, 
      more devices were implanted in blacks. At 1-year, non-whites (vs. whites) and 
      blacks (vs. non-blacks or whites) experienced higher cumulative incidence of the 
      primary outcome (32.9% vs. 22.5%, p = 0.002 and 38.6% vs. 23.4% or 22.5%, p 
      = 0.002 or p = 0.001, respectively), which were accounted for by hospitalizations 
      in the functional MR sub-cohort (n = 494). NYHA class improved less among blacks 
      with functional MR. MR severity and LVMi equally regressed in all groups. White 
      race (HR 0.62, 95% CI 0.39-0.99, p = 0.047) and black race (HR 2.07, 95% CI 
      1.28-3.35, p = 0.003) were independently associated with the primary outcome in 
      functional MR patients only. CONCLUSION: Mitral TEER patients of different racial 
      backgrounds exhibit major differences in baseline characteristics. Among those 
      with functional MR, non-whites and blacks also experience a less favorable 1-year 
      clinical outcome.
CI  - Copyright (c) 2023 Shechter, Kaewkes, Makar, Patel, Koren, Koseki, Solanki, 
      Dhillon, Nagasaka, Skaf, Chakravarty, Makkar and Siegel.
FAU - Shechter, Alon
AU  - Shechter A
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
AD  - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Kaewkes, Danon
AU  - Kaewkes D
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 
      Thailand.
FAU - Makar, Moody
AU  - Makar M
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Patel, Vivek
AU  - Patel V
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Koren, Ofir
AU  - Koren O
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, 
      Israel.
FAU - Koseki, Keita
AU  - Koseki K
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
FAU - Solanki, Aum
AU  - Solanki A
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Dhillon, Manvir
AU  - Dhillon M
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Nagasaka, Takashi
AU  - Nagasaka T
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - Department of Cardiovascular Medicine, Gunma University Graduate School of 
      Medicine, Maebashi, Gunma, Japan.
FAU - Skaf, Sabah
AU  - Skaf S
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Chakravarty, Tarun
AU  - Chakravarty T
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Makkar, Raj R
AU  - Makkar RR
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
FAU - Siegel, Robert J
AU  - Siegel RJ
AD  - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los 
      Angeles, CA, United States.
AD  - David Geffen School of Medicine, University of California, Los Angeles, Los 
      Angeles, CA, United States.
LA  - eng
PT  - Journal Article
DEP - 20230302
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC10018123
OTO - NOTNLM
OT  - MitraClip
OT  - mitral regurgitation
OT  - mitral transcatheter edge-to-edge repair
OT  - racial disparities
OT  - transcatheter mitral valve repair
COIS- RM received grant support from Edwards Lifesciences Corporation, is a consultant 
      for Abbott Vascular, Cordis, and Medtronic, and holds equity in Entourage 
      Medical. TC is a consultant, proctor, and speaker for Edwards Lifesciences and 
      Medtronic, is a consultant for Abbott Lifesciences, and is a consultant and 
      speaker for Boston Scientific. The remaining authors declare that the research 
      was conducted in the absence of any commercial or financial relationships that 
      could be construed as a potential conflict of interest.
EDAT- 2023/03/21 06:00
MHDA- 2023/03/21 06:01
PMCR- 2023/01/01
CRDT- 2023/03/20 04:11
PHST- 2022/11/30 00:00 [received]
PHST- 2023/02/09 00:00 [accepted]
PHST- 2023/03/20 04:11 [entrez]
PHST- 2023/03/21 06:00 [pubmed]
PHST- 2023/03/21 06:01 [medline]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2023.1111714 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Mar 2;10:1111714. doi: 10.3389/fcvm.2023.1111714. 
      eCollection 2023.